Effect of a cognitive task and light finger touch on standing balance in healthy adults

Exploring the impact of gentle stroking touch on psychophysiological regulation of inhibitory control

Touch has been shown to regulate emotions, stress responses, and physical pain. However, its impact on cognitive functions, such as inhibitory control, remains relatively understudied. In this experiment, we explored the effects of low-force, slow-moving touch-designed to optimally activate unmyelinated cutaneous low-threshold mechanoreceptor C-tactile (CT) afferents in human hairy skin-on inhibitory control and its psychophysiological correlates using the Stroop Task, a classic paradigm commonly employed to assess inhibitory control capacity. The Stroop Task was repeated twice before and once after receiving either gentle touch or no-touch. Participants were assigned to two groups: the touch group (n = 36), which received low-force, slow-moving touch on their forearms at a stroking velocity of ~3 cm/s, and the no-touch group (n = 36), which did not receive any touch stimulation. Changes in autonomic nervous system activity were also assessed by measuring heart rate variability (HRV) and skin conductance levels before and during cognitive performance. Compared to the no-touch group, participants who received gentle, low-force, slow-moving touch demonstrated faster responses and higher HRV during the Stroop Task. Additionally, within the touch group, individuals with higher HRV exhibited even quicker performance on the cognitive task. While we cannot draw definitive conclusions regarding the CT velocity-specific effect, these results provide preliminary evidence that low-force, slow-moving touch may influence cognitive processes involved in the inhibitory control of goal-irrelevant stimuli.

Attention and control of posture: the effects of light touch on the center-of-pressure time series regularity and simple reaction time task

The stabilizing influence of a light touch (LT) on a postural sway has been consistently shown in the literature, however there is still no consensus in what way attentional resources are used when adopting LT during standing. To better elucidate the underlying mechanisms we introduced additional feedback (LT), which seems to distracts from postural control, and verified it by center of pressure (COP) regularity level and simple reaction time task. 25 healthy students randomly performed eight postural tasks, four without (NoRT)/ four with simple reaction task (RT). COP displacements were measured on a force plate in two visual conditions: eyes open/closed and two sensory conditions: without (NoLT)/with light touch (LT). Participants were asked to consider the postural task as the primary task. Although simple reaction time did not differ between postural conditions (p > 0.05), LT decreased postural sway velocity in anteroposterior direction (p < 0.001, η2 = 0.86) and decreased standard deviation (p < 0.001, η2 = 0.91) in both, reaction and visual conditions. Interestingly, RT task modified subjects behavior in NoLT conditions and caused slower COP velocity (p < 0.001, η2 = 0.53) without changes in signal regularity. Results also showed a significant increase in irregularity during standing with LT (p < 0.001, η2 = 0.86) in both vision and reaction conditions, suggesting that the signal was more random. Current results suggests that providing LT enhance postural steadiness and also seem to redirect attention externally, as shown by increased signal irregularity. Hence, LT possibly reduce the attention invested in the postural task itself. A RT task can be not sensitive enough to detect such subtle changes.

Distinguishing among standing postures with machine learning-based classification algorithms

The purpose of our study was to evaluate the accuracy with which classification algorithms could distinguish among standing postures based on center-of-pressure (CoP) trajectories. We performed a secondary analysis of published data from three studies: Study A) assessment of balance control on firm or foam surfaces with eyes-open or closed, Study B) quantification of postural sway in forward-backward and side-to-side directions during four standing-balance tasks that differed in difficulty, and Study C) an evaluation of the impact of two modes of transcutaneous electrical nerve stimulation on balance control in older adults. Three classification algorithms (decision tree, random forest, and k-nearest neighbor) were used to classify standing postures based on the extracted features from CoP trajectories in both the time and time-frequency domains. Such classifications enable the identification of differences and similarities in control strategy. Our results, especially those involving time-frequency features, demonstrated that distinct CoP trajectories could be identified from the extracted features in all conditions and postures in each study. Although the overall classification accuracy was similar using time-frequency features (~ 86%) for the three studies, there were substantial differences in accuracy across conditions and postures in Studies A and B but not in Study C. Nonetheless, the models were far superior to the published results with conventional metrics in distinguishing between the conditions and postures. Moreover, a Shapley Additive exPlanation analysis was able to identify the most important features that contributed to the classification performance of the models.

Effect of sit-stand workstation position and computer task on head and trunk postural sway and discomfort

Adjustable-height desks may provide musculoskeletal health benefits to offset the effects of prolonged sitting. One mechanism may be increased postural variability, here characterized by head and trunk postural sway. Linear acceleration of the head and trunk were measured while participants used computer workstations in seated and standing positions during keyboard and mouse tasks; secondary measures were discomfort and proprioception (head and neck repositioning error). Median accelerations of the head and trunk were 20-26% lower in mouse tasks compared to keyboard tasks (p < 0.01). There were no significant differences in sway parameters between seated and standing positions. Discomfort and proprioception were correlated; subjects who experienced increased neck discomfort after 1.5 h of computer work had almost twice the head and neck repositioning error. The results suggest that postural sway is more affected by different tasks (keyboard vs. mouse) than by different workstation configurations and that low proprioception acuity may relate to the development of discomfort.

Touch may reduce cognitive load during assisted typing by individuals with developmental disabilities

Many techniques have attempted to provide physical support to ease the execution of a typing task by individuals with developmental disabilities (DD). These techniques have been controversial due to concerns that the support provider's touch can influence the typed content. The most common interpretation of assisted typing as an ideomotor phenomenon has been qualified recently by studies showing that users with DD make identifiable contributions to the process. This paper suggests a neurophysiological pathway by which touch could lower the cognitive load of seated typing by people with DD. The required sensorimotor processes (stabilizing posture and planning and executing manual reaching movements) and cognitive operations (generating and transcribing linguistic material) place concurrent demands on cognitive resources, particularly executive function (EF). A range of developmental disabilities are characterized by deficits in sensorimotor and EF capacity. As light touch has been shown to facilitate postural coordination, it is proposed that a facilitator's touch could assist the seated typist with sensorimotor and EF deficits by reducing their sensorimotor workload and thereby freeing up shared cognitive resources for the linguistic elements of the task. This is the first theoretical framework for understanding how a facilitator's touch may assist individuals with DD to contribute linguistic content during touch-assisted typing.

Assessing upper extremity-cognitive dual-task ability in neurological populations: A systematic review

BACKGROUND

Dual-task involves performing cognitive and motor tasks together, which requires executive functions that may be impaired in individuals with neurological conditions. Therefore, it is important to accurately assess executive functions to plan a therapeutic intervention.

OBJECTIVE

To characterize the use of upper extremity-cognitive dual-task assessment and to describe variables correlated with dual-task ability.

METHODS

An electronic search of databases (MEDLINE, EMBASE, CINAHL, and PsycINFO) was carried out using a combination of the following terms: upper-extremity, dual/concurrent task, and cognitive/motor tasks. Two reviewers independently completed data extraction and assessed study quality.

RESULTS

1,946 studies were identified; 25 studies met the inclusion criteria. The purpose of using an upper extremity-cognitive dual-task assessment varied between studies as well as the upper extremity motor tasks used: pegboard (N = 14), arm curl (N = 9), finger-tapping (N = 3), and reaching (N = 1) tests. Dual-task ability was reported as the motor-cognitive interference (N = 15) and as motor cost (N = 12). Dual-task ability was correlated to cognition, brain activity, and daily function, and was significantly different between healthy and neurological individuals.

CONCLUSION

Upper extremity cognitive dual-task paradigm is gaining popularity in clinical research, but lacks standardized tools, testing procedures, and calculations. A structured assessment procedure is needed for clinical use and future research.

Aging effects of haptic input on postural control under a dual-task paradigm

Postural control relies on three principal sensory systems: vision, vestibular and proprioceptive; that are affected by aging. When performing a cognitive task concomitantly with a motor task, those sensory impairments lead to even greater deleterious effects on balance. We aimed to study the effects of a sensory aid (a light touch) on a dual task paradigm and sought to understand the different responses on balance due to aging. Fifty healthy and highly physical active women were divided in two groups: young (N = 25, 24.2 ± 4.0 years) and older adults (N = 25, 67.3 ± 4.2 years). In a random and balanced order, all participants performed five tasks: Stroop test while seated (Seated); Stroop test while standing quiet (ST); Standing quiet (BL); Standing quiet with a haptic input (LT); and Stroop test with a haptic input while standing quiet (SL). In the Stroop test, older women committed more errors (50 vs 11 errors, p < 0.001) and had higher reaction time (1.001 ± 0.191 vs 0.699 ± 0.081 s, p < 0.001). The haptic input (LT) reduced all body sway parameters, in both groups, regardless the condition. This means that postural control under a dual task paradigm (ST) deleterious effect can be mitigated by a haptic input.

Cognitive processes and a centre-of-pressure error-based moving light-touch biofeedback

Lightly touching an earth-fixed external surface with the forefinger provides somatosensory information that reduces the center of pressure (CoP) oscillations. If this surface were to move slowly, the central nervous system (CNS) would misinterpret its movement as body self-motion, and involuntary compensatory sway responses would appear, resulting in a significant coupling between finger and CoP motions. We designed a forefinger moving light-touch biofeedback based on this finding, which controls the surface velocity to drive the CoP towards a target position. Here, we investigate this biofeedback resistance to cognitive processes. In addition to a baseline, the experimental protocol includes four main conditions. In the first, participants were utterly naive about the feedback. Then, they received additional reliable sensory information. The third condition ensured their full awareness of the external nature of the surface motion. Finally, the experimenter notified them that the external motion drives their balance and asked them to reject its influence. Our investigation shows that despite the robustness of the proposed biofeedback, light-touch remains penetrable by cognitive processes. For participants to dramatically reduce the existing coupling between the finger and CoP motions, they should be aware of the external motion, how it impacts sway, and actively reject its influence. The main implication of our findings is that light-touch exhibits the same cognitive flexibility as vision when artificially stimulated. This could be interpreted as a defense mechanism to re-weight these two sensory inputs in a moving environment.

Individual and combined effects of a cognitive task, light finger touch, and vision on standing balance in older adults with mild cognitive impairment

BACKGROUND

Postural instability and balance dysfunction have been identified in older adults with mild cognitive impairment (MCI). Performing a secondary task while standing can additionally jeopardize their balance.

AIMS

The purpose of the exploratory study was to investigate the individual and combined effects of a cognitive task, light finger touch and vision on postural sway in older adults with MCI as compared to healthy older adults.

METHODS

Five individuals with MCI and ten age-matched control subjects stood on the force platform with and without the performance of a cognitive task (counting backward from a randomly chosen three-digit number), with and without light finger touch contact applied to an external stable structure, and with eyes open or closed. The center of pressure (COP) excursion, range, velocity in antero-posterior and medial-lateral directions and sway area were calculated.

RESULTS

Participants demonstrated significantly larger postural sway when vision was not available (p < 0.05), smaller postural sway when using a finger touch contact (p < 0.05) and increased postural sway during the performance of the cognitive task (p < 0.05). When finger touch and a cognitive task were performed simultaneously, body sway decreased as compared to just standing in healthy older adults but not in individuals with MCI (p < 0.05).

CONCLUSIONS

The results help to better understand the individual and combined effects of vision, light touch and a cognitive task in postural control of individuals with MCI. The study outcome also provides a basis for future studies of balance control in patients with cognitive impairments.

Effect of Light Finger Touch, a Cognitive Task, and Vision on Standing Balance in Stroke

The aim of the exploratory study was to investigate the individual and combined effects of light finger touch, a cognitive task, and vision on postural sway in individuals with stroke. Nine older adults with stroke stood on the force platform with eyes open and eyes closed, with and without a light finger touch contact with the stationary frame, and when counting backward from a randomly chosen three-digit number or without it. The center of pressure (COP) excursion, velocity, range and sway area was calculated. Participants demonstrated significantly larger postural sway when vision was not available (p < 0.05), smaller postural sway when using a finger touch contact (p < 0.05), and increased postural sway while performing the cognitive task (p < 0.05). When finger touch and a cognitive task was performed simultaneously, body sway decreased as compared to standing and performing a cognitive task in eyes open (p < 0.05) and eyes closed conditions. Results indicate that light touch in individuals with stroke mitigates the impact of cognitive load. The findings contribute to the understanding of the role of sensory integration in balance control of individuals with neurological impairments and older adults.

Anticipatory and compensatory postural adjustments in response to loading perturbation of unknown magnitude

In response to sudden postural perturbations, the posture control system uses anticipatory and compensatory postural adjustments (APAs and CPAs) to maintain balance and equilibrium. APAs strengthen as the perturbation magnitude increases, while CPAs remain constant because APAs make the necessary adjustments. However, the magnitude of a postural perturbation cannot always be fully known. This research focused on postural adjustments in response to perturbations with unknown magnitude. Participants caught falling sandbags of three weights on a tray held in their hands. Participants were told about the weight used for the upcoming trial in the KNOWN condition and not told in the UNKNOWN condition. Surface electromyography (sEMG) of the lumbar muscles and displacement of the center of pressure (COP) were recorded synchronously. The results showed that APAs and CPAs were stronger in the UNKNOWN condition than in the KNOWN condition. Meanwhile, in the UNKNOWN condition, the activity of the lumbar muscles and displacements of the COP showed no difference between weight levels. The lumbar erector spinae (LES) and lumbar multifidus (LMF) activated earlier in the UNKNOWN condition than for the heaviest weight in the KNOWN condition. The outcome of this study indicates that APAs and CPAs of lumbar muscles and displacements of the COP are affected by the knowledge of postural perturbations. The central nervous system (CNS) coped with load perturbations of unknown magnitude with redundancy response strategy, based on the maximum assumption of perturbation magnitude.